Key result
Administration of half-dose intravenous tissue plasminogen activator combined with anticoagulation resulted in survival for a 32-year-old female with postoperative acute pulmonary embolism and right heart thrombus in transit.
Why the study?
Right heart thrombus in transit associated with pulmonary thromboembolism is rare and potentially fatal, and case reports help inform whether and when thrombolysis should be administered.
Does half-dose intravenous TPA with anticoagulation improve survival in a postoperative patient with saddle pulmonary embolism and right heart thrombus in transit?
Case Report (n=1)
Does half-dose intravenous TPA with anticoagulation improve survival in a postoperative patient with saddle pulmonary embolism and right heart thrombus in transit?
This case report suggests that half-dose intravenous TPA combined with anticoagulation can be successfully used to treat postoperative saddle pulmonary embolism with right heart thrombus in transit.
Answers are grounded in this paper and cite their sources.
May prompt echocardiography in young postoperative PE patients; leaves open optimal RHTT management strategies.
Right heart thrombus in transit clot (RHTT) associated with a pulmonary thromboembolism (PTE) is a rare but potentially fatal diagnosis. Early diagnosis and immediate intervention are crucial. This report describes the case of a healthy, physically active 32-year-old female who presented 19 days postoperatively, following an anterior cruciate ligament reconstruction and partial lateral meniscectomy with a saddle PE, RHTT, and right ventricular (RV) strain. The patient received half of the standard dose of intravenous tissue plasminogen activator (TPA) in combination with anticoagulation and survived. Case reports of RHTT will inform future studies designed to evaluate whether and when thrombolysis should be administered.
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Mardinger et al. (2020) conducted a case report in Postoperative acute pulmonary embolism with right heart thrombus in transit (n=1). Intravenous tissue plasminogen activator (TPA) in combination with anticoagulation was evaluated on Survival. Administration of half-dose intravenous tissue plasminogen activator combined with anticoagulation resulted in survival for a 32-year-old female with postoperative acute pulmonary embolism and right heart thrombus in transit.
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